Retrospective Comparison of the Effects of Intrathecal Morphine and Erector Spinae Plane Block on Postoperative Analgesia in Patients Undergoing VATS
Buket Kocamanoğlu, Cengiz Kaya, Esra Turunç, Halil Cebeci, Elif Bengi Şener, Ismail Serhat KocamanoğluDepartment of Anesthesiology and Reanimation, Ondokuz Mayıs University Faculty of Medicine, Samsun, TürkiyeObjectives: This study evaluates the analgesic effects of intrathecal morphine (ITM) and ultrasound-guided erector spinae plane block (ESPB) in managing postoperative pain following video-assisted thoracoscopic surgery (VATS).
Methods: This retrospective observational study examined hospital records and anesthesia documents of 40 patients who underwent VATS at a university hospital between January 2021 and January 2022. The patients were divided into two groups: ITM and ESPB. The comparative analysis included cumulative morphine consumption within the initial 12/24 h after VATS, Numeric Rating Scale (NRS) resting/activity scores, rescue analgesic requirements, and the side effect profile.
Results: During the first 12 h postoperatively, the ITM group exhibited lower median morphine consumption than the ESPB group (ITM: 1.9 mg [0.85–3] vs. ESPB: 3.65 mg [3–4.23], p=0.003). Further, within the initial 24 h postoperatively, the ITM group also exhibited lower median morphine consumption compared to ESPB (ITM: 4 mg [1.54–5.38] vs. ESPB: 10 mg [10–10], p<0.001). The NRS resting/activity scores were consistently lower in the ITM group than in the ESPB group at all measurement times (p<0.001). The number of patients receiving rescue analgesic medication was lower in the ITM group than in the ESPB group (ITM, n=6 [30%] vs. ESPB, n=20 [100%]; p<0.001). The side effect profiles of both groups were comparable.
Conclusion: ITM reduced morphine consumption, pain scores, and the requirement for rescue analgesia compared with ESPB, with a comparable side effect profile after VATS.
Manuscript Language: English
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